Rare vascular variation associated with the presence of a persistent left superior vena cava: a case report

Persistent left superior venae cavae (PLSVCs) are often undiagnosed and asymptomatic in adults. Vascular variations accompanying PLSVCs are difficult to ascertain since the latter are typically diagnosed radiologically. Dissection activities, photogrammetry 3D imaging, and high-resolution computed tomography (microCT) revealed unusual variation in a 95-year-old male exhibiting a rare PLSVC. Accompanying the right-sided superior vena cava and bilateral azygos veins, a diminutive coronary sinus emptied directly into the PLSVC. No signs of obstructed venous return, obvious pathologies, or other cardiac developmental anomalies were identified. PLSVCs and associated variants may complicate cardiac procedures (e.g., pacemaker implantation, central venous catheterization, and surgery). While knowledge of PLSVCs and associated variants is important for all physicians, it is especially crucial in cardiothoracic procedures or trauma and emergency surgery when preoperative imaging may be unavailable, and lack of awareness can adversely impact surgical success.